The U.S. Food and Drug Administration announced it is
reviewing data involving a link between two drugs used to prevent organ
rejection and the developmental of progressive multifocal leukoencephalopathy (PML).
PML is rare but life-threatening disorder that affects the
central nervous system. The disease usually occurs when a patient’s immune
system is suppressed to disease or medicines. PML is caused by activation
resulting from unknown factors of a polyomavirus, also known as the JC virus,
which is latent in 80 percent of healthy adults.
Symptoms of PML include localized neurological signs, vision
changes, loss of coordination, clumsiness, memory loss, difficulty speaking or
understanding what others say and weakness in the legs.
The reviewed drugs are CellCept (mycophenolate mofetil),
manufactured by Hoffman-LaRoche Inc. and Myfortic (mycophenolic acid)
manufactured by Novartis Pharmaceuticals Inc. CellCept is approved to prevent
heart, liver and kidney transplant rejection, while Myfortic is approved to
prevent kidney transplant.
According to FDA representative Christopher Kelly, the
agency has received 16 reports of PML in CellCept patients since 1995 including
some deaths. The agency is currently checking its database to see if there were
additional cases, Kelly added.
A representative for Novartis said that the company was not
aware of any cases of the disease associated with the drug.
On the other hand, Roche representative Christopher Vancheri
said the company had 10 confirmed PML cases and 6 cases of possible PML.
The FDA said it may take about 2 months to complete its
review and as soon as it is finished, the agency will communicate the
conclusions and recommendations to the public.
“Until further information is available, patients and
healthcare professionals should be aware of the possibility of PML, such as
localized neurologic signs and symptoms in the setting of a suppressed immune
system, including during therapy with CellCept and Myfortic,” the FDA said on
its Web site.
However, patients shouldn’t change the way they use either
medication, during the ongoing review, the FDA added.
Both drugs received a black box warning last fall, warning about possible first-trimester miscarriage and congenital malformations. The ongoing review could also bring new warning information on the packages.